A Mini-Stroke Is a Serious Red Flag

A recent addition to the pages of Good Times magazine is “Your Health Questions,” in which we answer questions submitted by our readers about health, nutrition, and well-being.

Q – I’ve had a TIA (whatever that means) and want to learn more about that kind of stroke. Can you enlighten me?

A – A TIA (or transient ischemic attack, also known as a mini-stroke) is a situation in which someone experiences stroke symptoms that disappear over the course of a few minutes to a few hours, says Dr. Thomas Jeerakathil, a professor of neurology and medicine at the University of Alberta in Edmonton and the northern stroke lead with the Cardiovascular and Stroke Strategic Clinical Network at Alberta Health Services.

The culprit is the same as in most strokes. “The reason it occurs is that you have an artery that’s blocked off by a clot, which produces the symptoms of a stroke from lack of oxygen flow,” Jeerakathil explains. The difference between a TIA and a bona fide ischemic stroke is that “the clot opens spontaneously, so the symptoms go away.”

That the symptoms disappear—along with the name “mini-stroke”—may falsely reassure people that a TIA isn’t serious, but it’s a big red flag.

“It means that there’s some problem with the arteries to predispose you to a stroke,” Jeerakathil says. “A TIA is a sign that you have an elevated risk of having a stroke, particularly in the next three months. The risk is highest in the 48 hours afterwards, dropping slightly over the following week, and again at three weeks and three months.”

The symptoms you experience also factor into your risk for a recurrence. In the case of speech and motor problems—weakness on one side of the body, drooping on one side of the face, or slurred speech, for example, “you’re at a much higher risk,” Jeerakathil says. With sensory symptoms, such as tingling, or visual disturbances (which can have other causes, ranging from infection to migraine), the risk is lower.

Either way, it’s important to seek medical attention promptly (call 9-1-1 immediately in the case of motor and speech symptoms) to get a diagnosis and, if necessary, start treatment.

If you have indeed experienced a TIA, “we start you on blood thinners and usually cholesterol-lowering medication, as well,” Jeerakathil says. The blood thinners of choice are typically the weaker variety—Aspirin or a related drug called clopidogrel. Stronger relatives of these drugs are prescribed if you’re diagnosed with a heart rhythm disturbance called atrial fibrillation. “We also do a dietitian consult to try to optimize your diet,” he adds.

On the bright side, thanks to the coordinated delivery of this type of treatment via the kind of organized stroke-focused medical care that’s been adopted in many Canadian jurisdictions, the outlook for people who’ve experienced TIAs has improved. “It used to be that the recurrence risk for a stroke after TIA was 10 per cent at three months,” Jeerakathil says. “With organized stroke-focused medical care, it’s closer to four per cent.”

Unfortunately, if you’ve had a TIA, your risk for stroke remains several times higher than that of someone with no such history, but continuing to take your medications, eating a healthy diet, and exercising regularly can rein it in. “It’s always better to prevent a stroke than to try to treat one,” Jeerakathil stresses.

For more information on managing your risk for stroke, visit: heartandstroke.ca.